Health & Wellness to pursue paperless initiative

Instead of relying on paper charts and records to treat patients, the Hopkins Health and Wellness Center is in the process of adopting a paperless Electronic Medical Record. The switch is hoped to enhance documentation.

“Everything used to be kept in a paper chart; all the doctor’s notes, lab test results, all the x-ray reports,” Alain Joffe, Medical Director of the Center said. “We, in essence, have done away with 95 percent of that. Everything now is documented by typing into the com- puter or scanning results and creating, basically, images — so all of that is now in electronic format.”

The system that the Center will be using, a software program called P5, will allow the Center to do more than just house med- ical records.

Not only will there be a self check-in for students, but students will be able to complete forms online and print out portions of their medical record — immunizations records, for example. The new electronic medical record program also has a drug interaction and allergy monitoring system.

“I really think once we learn all the bells and whistles, it will make it better in a lot of different ways,” Joffe said. “It’ll make the documentation better, it’ll make coordination of care better. One example is of the allergy checker: if someone inadvertently prescribed a medication a student is allergic to, a warning field pops up. Another example is a drug-drug (or food-drug) interaction indicator.”

Joffe said the process was not one made overnight, and that it has been occurring slowly over the past decade. The initial makings of going paperless began when the Center purchased the beginnings of an Electronic Medical Record in 1998.

“It’s been going along very slowly. Initially the only thing that the Health Center used the Electronic Medical Record for was to code diagnoses and order laboratory tests,” Joffe said “Then probably about five years ago we upgraded to the next version and that allowed us to do a few more sophisticated things.”

Students are able to see the effect of this going paperless process in the filling out of medical forms online. Joffe said the past three classes (through the class of 2012) filled out these forms online.

“Rather than have students complete a paper and pencil form that they send to school that resided in the paper chart, we have you do that kind of stuff online,” he said. “This year’s class is probably the third class we’ve had do that. We’ve also had the graduate students start to do that. That was the next step in functionality.”

The company the Center uses was also in transition to a paperless system. As a result, Joffe said the Center had a decision to make as to whether or not to go completely paperless.

“The company that we used was in transition from a quasi-paperless record to a complete paperless record,” Joffe said. “Some of the stuff you guys did online wouldn’t transfer completely into your Electronic Medical Record. [In] the newest version, all the information will 100 percent transfer over. We are going to be pretty much paperless.”

Part of the paperless process involves the ability to check oneself in at a kiosk instead of having to manually sign in for an appointment.

“As soon as we get a few more things set up, students will be able to come in and check in at a kiosk. Let’s say you come in and the appointment is because of a head cold. We have certain forms that we’ve developed,” Joffe said.

“You’ll register, then you’ll check in, and a screen will pop up. You’ll have to complete a form right at the kiosk that will go into the EMR so that by the time you get to me I’ll pull up that form and see what you’ve completed.”

Joffe said that the Center is not the only place that is using the Electronic Medical Record. In comparison to other available technology, however, the Center’s program is very basic.

“Big hospitals and health systems need a much more sophisticated and powerful Electronic Medical Record system than most college health centers need, with a big price tag to match,” Joffe said. “So there are relatively few vendors that market to college health centers or EMRs that college health centers can afford.”

Lynn Stein, the Clinical Services Manager for the Health and Wellness Center went through training provided by the vendor. The process lasted three days. Though the program that the Center currently uses is the same program from 1998, Stein wrote in an email to The News-Letter that the newest version of it was built on a totally different platform. A test version and production version were both received in December.

Stein provided training for the Center, and wrote that providing training was a collaborative process.

“A vendor can only provide knowledge of the program’s capabilities as each health center operates differently,” Stein wrote “As a trainer, I am not a medical person. So, it was a three-way process. We taught each other in many ways. Everyone, including health care providers, was ready to make this change knowing it would not be easy.

“The health care providers were shown the test version and had the opportunity to ask questions and voice their concerns and provide input as to how it should work. Initially, I was ten steps ahead of them, but I’m lucky now if I can stay one step ahead of them. They’ve been wonderful with helping each other and have no trouble asking for things they need to make it work for them.”

Joffe said he is optimistic about the advancements.

“Being able to do self check-in and also complete any associated forms without having to go to the registration desk would be a plus,” he said. “In six months, when every piece is talking to every other piece and everything is working smoothly it will be a net benefit to everybody — for you guys [and] for us — I’m very positive about it.”